头皮血管畸形的外科治疗

Surgical treatment of scalp vascular malformation

目的：讨论有关头皮血管畸形的诊断和治疗问题。方法：３２例头皮血管畸形经显微手术全切除。年龄６～５９岁，１４岁以下儿童１１例，平均年龄２８．４岁。畸形血管直径３～５ｃｍ１１例，５～１０ｃｍ１８例，大于１０ｃｍ３例。结果：经病理证实毛细血管畸形１例，海绵状血管瘤４例，动静脉畸形２７例。３２例随访１２～４０月，平均１８月，未见复发。结论：头皮血管畸形属先天畸形，但也可能与头部外伤有关，本组４例有头部外伤史。本病以手术切除最为彻底。脑血管造影是确诊的重要手段。单纯颞浅动脉供血属普通型。脑膜中动脉和颈内动脉参与供血属复杂型。

Objective: To discuss the diagnosis and treatment of the scalp vascular malformation. Methods: 32 cases of scalp vascular malformation aged from 6 to 59 years old (average age is 284 years old, and 11 cases below 14.) were all treated by microsurgical totally resection. 11 cases with the diameter of the malformed vessels 3 to 5cm, 18 cases with 5 to 10cm and 3 cases with over 10cm. Results: 1 case of capillary malformation, 4 cases of cavernous hemangioma and 27 cases of AVM were verified by postoperative pathological examination. With a follow up of 12 to 40 months (mean 18 months), no recurrence was found. Conclusion: Scalp vascular malformation belongs to congenital malformation, but may be associated with head trauma (4 cases in this group). The best treatment was thorough removal with microsurgical technique. This disease was classified into two types by angiogram: common type, feeding by superficial temporal artery; participating type, feeding by both middle meningial artery and internal carotid artery.